全球弱視人口大約占2~5%，弱視影響了日常生活和往後的學習發展。人類的視覺系統發展，必須透過清晰的影像呈現在視網膜，刺激視神經發育，視力才會慢慢地進步，6 歲以前是視力發展的黃金時期，若沒有接受到適當的刺激，會導致視神經發育不完全，形成弱視。目前臨床常用的弱視訓練儀，是利用黑白旋轉光柵作為刺激，訓練時遮住視力較佳的眼睛在光柵上描圖。家長必須每週陪同小朋友到診所做訓練，重複的描圖訓練也讓小朋友感到無趣。近年來也有許多弱視訓練方面的研究，改以電腦遊戲的方式作為訓練，刺激仍以光柵為主，但大多沒有做長期的追蹤，且只以視力和對比敏感度為主要評估的依據。
本計畫設計了一套在平板電腦上的居家型的弱視訓練機，訓練方式以傳統的弱視訓練儀為基礎，並結合遊戲，讓小朋友輕鬆、愉快地在家做訓練。本研究針對每位受試者進行長達半年的追蹤，並透過五種方式(視力、空間頻率、對比敏感度、瞬態視覺誘發電位和穩態視覺誘發電位)進行完善的效果評估。目前已完成兩個月的評估，大部分的受試者已有明顯的改善，平均改善為0.14。

The prevalence of worldwide population with amblyopia is 2-5%. Amblyopia affects the daily life and learning ability. The human visual system can be developed normally with exposure of clear images on the retina, which often drive the development of optic nerves progressively. In general, the visual acuity progresses gradually with age, it is relatively mature until 6 years old. The Cambridge Stimulator (CAM) with rotating grating is commonly used in clinic. The CAM allows subjects to draw pictures on the grating with occlusion of the dominant eye. The CAM usually makes children be uninteresting, and parents have to go with their children to a hospital. Recently, some computer games have been incorporated with CAM training. Moreover, most of these studies didn’t have long-term tracking, and they only used limited assessments.
This study creates a home-based training on tablet. The training is based on CAM and integrated into a game. The system integrates with clinical information. This study has long-term tracking (six months), and five evaluations are used, including visual acuity, grating acuity, grating contrast transient visual evoked potential and steady-state visual evoked potential. Most of subjects have been improved significantly after 2 months training. The mean of improvement is 0.14 logMAR.

[1] K. Attebo, P. Mitchell, R. Cumming, W. Smith, N. Jolly, and R. Sparkes, "Prevalence and causes of amblyopia in an adult population," Ophthalmology, vol. 105, pp. 154-159, 1998.
[2] K. W. Wright, P. H. Spiegel, L. S. Thompson, T. C. Hengst, S. Gilbert, and F. Cogswell, Handbook of pediatric strabismus and amblyopia vol. 5: Springer, 2006.
[3] N. W. Daw and N. W. Daw, Visual development: Springer, 2006.
[4] S. Loudon and H. Simonsz, "The history of the treatment of amblyopia," Strabismus, vol. 13, pp. 93-106, 2005.
[5] P. E. D. I. Group, "Impact of patching and atropine treatment on the child and family in the amblyopia treatment study," Archives of Ophthalmology, vol. 121, p. 1625, 2003.
[6] F. W. Campbell, R. F. Hess, P. G. Watson, and R. Banks, "Preliminary results of a physiologically based treatment of amblyopia," British Journal of Ophthalmology, vol. 62, pp. 748-755, 1978.
[7] M. Cleary, A. Moody, A. Buchanan, H. Stewart, and G. Dutton, "Assessment of a computer-based treatment for older amblyopes: the Glasgow Pilot Study," Eye, vol. 23, pp. 124-131, 2007.
[8] U. Kämpf, A. Shamshinova, T. Kaschtschenko, W. Mascolus, L. Pillunat, and W. Haase, "Long-term application of computer-based pleoptics in home therapy: selected results of a prospective multicenter study," Strabismus, vol. 16, pp. 149-158, 2008.
[9] L. To, B. Thompson, J. R. Blum, G. Maehara, R. F. Hess, and J. R. Cooperstock, "A game platform for treatment of amblyopia," Neural Systems and Rehabilitation Engineering, IEEE Transactions on, vol. 19, pp. 280-289, 2011.
[10] Captain lazy eye. Available: http://www.ideabus.com.tw/lazyeye/index_EN.php
[11] A. T. Astle, B. S. Webb, and P. V. McGraw, "The pattern of learned visual improvements in adult amblyopia," Investigative ophthalmology & visual science, vol. 52, pp. 7195-7204, 2011.
[12] X.-Y. Liu, T. Zhang, Y.-L. Jia, N.-L. Wang, and C. Yu, "The therapeutic impact of perceptual learning on juvenile amblyopia with or without previous patching treatment," Investigative ophthalmology & visual science, vol. 52, pp. 1531-1538, 2011.
[13] Y. Zhou, C. Huang, P. Xu, L. Tao, Z. Qiu, X. Li, et al., "Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia," Vision research, vol. 46, pp. 739-750, 2006.
[14] R. H. F. de Mendonça, S. Abbruzzese, B. Bagolini, I. Nofroni, E. L. Ferreira, and J. V. Odom, "Visual evoked potential importance in the complex mechanism of amblyopia," International ophthalmology, vol. 33, pp. 515-519, 2013.
[15] J. Heravian, R. Daneshvar, F. Dashti, A. Azimi, H. O. Moghaddam, A. Yekta, et al., "Simultaneous pattern visual evoked potential and pattern electroretinogram in strabismic and anisometropic amblyopia," Iranian Red Crescent Medical Journal, vol. 13, p. 21, 2011.
[16] D. J. Creel, "Visually Evoked Potentials."
[17] Y. Wang, X. Gao, B. Hong, C. Jia, and S. Gao, "Brain-computer interfaces based on visual evoked potentials," Engineering in Medicine and Biology Magazine, IEEE, vol. 27, pp. 64-71, 2008.
[18] X. Gao, D. Xu, M. Cheng, and S. Gao, "A BCI-based environmental controller for the motion-disabled," Neural Systems and Rehabilitation Engineering, IEEE Transactions on, vol. 11, pp. 137-140, 2003.
[19] Y. Wang, R. Wang, X. Gao, B. Hong, and S. Gao, "A practical VEP-based brain-computer interface," Neural Systems and Rehabilitation Engineering, IEEE Transactions on, vol. 14, pp. 234-240, 2006.
[20] Y.-T. Wang, Y. Wang, and T.-P. Jung, "A cell-phone-based brain–computer interface for communication in daily life," Journal of neural engineering, vol. 8, p. 025018, 2011.
[21] C. S. Herrmann, "Human EEG responses to 1–100 Hz flicker: resonance phenomena in visual cortex and their potential correlation to cognitive phenomena," Experimental brain research, vol. 137, pp. 346-353, 2001.
[22] U. Polat, T. Ma-Naim, M. Belkin, and D. Sagi, "Improving vision in adult amblyopia by perceptual learning," Proceedings of the National Academy of Sciences of the United States of America, vol. 101, pp. 6692-6697, 2004.
[23] L. Gammaitoni, P. Hänggi, P. Jung, and F. Marchesoni, "Stochastic resonance," Reviews of modern physics, vol. 70, p. 223, 1998.
[24] E. Simonotto, M. Riani, C. Seife, M. Roberts, J. Twitty, and F. Moss, "Visual perception of stochastic resonance," Physical Review Letters, vol. 78, pp. 1186-1189, 1997.
[25] C. A. Hazel and D. B. Elliott, "The dependency of logMAR visual acuity measurements on chart design and scoring rule," Optometry & Vision Science, vol. 79, pp. 788-792, 2002.
[26] W. Schneider, A. Eschman, and A. Zuccolotto, E-Prime: User's guide: Psychology Software Incorporated, 2002.